title: Elschnig pearl formation along the posterior capsulotomy margin after neodymium:YAG capsulotomy.
abstract: OBJECTIVE
  To determine the incidence of Elschnig pearl formation along the capsulotomy margin (string of pearls) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy and to elucidate its clinical features, predisposing factors, effect on visual function, and association with additional capsulotomy.
  
  
  METHODS
  Keio University Hospital, Tokyo, Japan.
  
  
  METHODS
  The records of 418 eyes that had had Nd:YAG posterior capsulotomy after cataract surgery were retrospectively reviewed. Of those, 315 were excluded for short follow-up (fewer than 12 months) or insufficient clinical examination data. In the remaining 103 eyes, the incidence of string of pearls was calculated, and its clinical features, predisposing factors, effect on visual function, and correlation with additional capsulotomy were evaluated.
  
  
  RESULTS
  String of pearls was identified in 49 eyes (47.6%); 37 (75.5%) developed pearls within 1 year after Nd:YAG capsulotomy. The incidence was significantly higher in patients having intraocular lens implantation and continuous curvilinear capsulorhexis (CCC) than in those without (95.9 versus 61.1% and 97.9 versus 55.6%, respectively). No significant differences were found in patient age and sex, total Nd:YAG energy, and the presence of diabetes mellitus or high myopia. String of pearls caused visual disturbances in 17 eyes (34.7%). The rate of repeat capsulotomy was higher in patients with string of pearls than in those without (36.7 and 9.3%, respectively).
  
  
  CONCLUSIONS
  String of pearls formation was a common and significant complication after Nd:YAG posterior capsulotomy. Intraocular lens implantation and CCC may promote its formation.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: D
authors.initials: D
authors.lastname: Kurosaka
authors.forename: H
authors.initials: H
authors.lastname: Bissen-Miyajima
authors.forename: K
authors.initials: K
authors.lastname: Negishi
authors.forename: E
authors.initials: E
authors.lastname: Hara
authors.forename: T
authors.initials: T
authors.lastname: Nagamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019923:Capsulorhexis / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000009:adverse effects*; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology